By Abou-Alfa, Ghassan K., MD

March 21, 2017

You are going home with a peripherally inserted central catheter (PICC). This small, soft tube has been placed in a vein in your arm. It is often used when treatment requires medicines or nutrition for weeks or months. At home, you need to take care of your PICC to keep it working. Because a PICC line has a high infection risk, you must take extra care washing your hands and preventing the spread of germs. This sheet will help you remember what to do to care for your PICC at home.

Understanding your role

A nurse or other healthcare provider will teach you and your caregivers how to care for the PICC. Before leaving the hospital, make sure you understand what to do at home, how long you may need the PICC, and when to have a follow-up visit.

You will likely be told to flush the PICC with saline or heparin solution. You may also be told to change the catheter’s injection caps and change the dressing (bandage). Or, a nurse may do this for you during a follow-up visit. Only do these things if you’re told to, following the instructions you were given.

Protecting the PICC

If the PICC gets damaged, it won’t work right and could raise your chance of infection. Call your healthcare team right away if any damage occurs. To protect the PICC at home:

Prevent infection. Use good hand hygiene by following the guidelines on this sheet. Don’t touch the catheter or dressing unless you need to. And always clean your hands before and after you come in contact with any part of the PICC. Your caregivers, family members, and any visitors should use good hand hygiene, too.

Keep the PICC dry. The catheter and dressing must stay dry. Don’t take baths, go swimming, use a hot tub, or do other things that could get the PICC wet. Take a sponge bath to avoid getting your catheter wet, unless your healthcare provider tells you otherwise. Ask your provider about the best way to keep your catheter dry when bathing or showering. If the dressing does get wet, change it only if you have been shown how. Otherwise, call your healthcare team right away for help.

Avoid damage. Don’t use any sharp or pointy objects around the catheter. This includes scissors, pins, knives, razors, or anything else that could cut it or put a hole in it (puncture it). Also, don’t let anything pull or rub on the catheter, such as clothing.

Watch for signs of problems. Pay attention to how much of the catheter sticks out from your skin. If this changes at all, let your healthcare provider know. Also watch for cracks, leaks, or other damage. If the dressing becomes dirty, loose, or wet, change it (if you have been instructed to). Or call your healthcare team right away.

Avoid lowering your chest below your waist. This includes bending at the waist to do things like tying your shoes. When your chest is below your waist, especially for a long time, the catheter’s internal tip could slip out of place in the vein.

Tell your healthcare team if you vomit or have severe coughing. This can also make the catheter slip out of place.

Protecting your arm

The arm with the PICC is at risk for developing blood clots (thrombosis). This is a serious problem. To help prevent it:

As much as possible, use the arm with the PICC in it for normal daily activities. Lack of movement can lead to blood clots. So it’s important to move your arm as you normally would. Your healthcare team may suggest light arm exercises.

Avoid activities or exercises that require major use of your arm, such as sports, unless your healthcare provider says it’s OK.

Avoid any activities that cause mild pain in your arm. Talk to your healthcare team if you have concerns about pain or range of motion.

Prevent infection with good hand hygiene

A PICC can let germs into your body. This can lead to serious and sometimes deadly infections. To prevent infection, it’s very important that you, your caregivers, and others around you use good hand hygiene. This means washing your hands well with soap and water, and cleaning them with an alcohol-based hand gel as directed. Never touch the PICC or dressing without first using one of these methods.

Rub your hands together vigorously for at least 15 seconds. Make sure to rub the front and back of each hand up to the wrist, your fingers and fingernails, between the fingers, and each thumb.

Rinse your hands with warm water.

Dry your hands completely with a new, unused paper towel. Don’t use a cloth towel or other reusable towel. These can harbor germs.

Use the paper towel to turn off the faucet, then throw it away. If you’re in a bathroom, also use a paper towel to open the door instead of touching the handle.

When you don’t have access to soap and water: Use an alcohol-based hand gel to clean your hands. The gel should have at least 60% alcohol. Follow the instructions on the package. Your healthcare team can answer any questions you have about when to use hand gel, or when it’s better to wash with soap and water.

When to seek medical care

Call your provider right away if you have any of the following:

Pain or burning in your shoulder, chest, back, arm, or leg

Fever of 100.4°F (38.0°C) or higher

Chills

Signs of infection at the catheter site (pain, redness, drainage, burning, or stinging)